The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

Severity of nausea and vomiting in pregnancy and early childhood neurobehavioral outcomes: the Growing Up in Singapore Towards Healthy Outcomes study

Severity of nausea and vomiting in pregnancy and early childhood neurobehavioral outcomes: the Growing Up in Singapore Towards Healthy Outcomes study
Severity of nausea and vomiting in pregnancy and early childhood neurobehavioral outcomes: the Growing Up in Singapore Towards Healthy Outcomes study
Background: nausea and vomiting of pregnancy (NVP) affects 50 to 80 percent of women. The existing literature has examined NVP from the perspective of the mother, and relatively less is known about offspring outcomes.

Objectives: to study the relationships of NVP with social-emotional, behavioral, and cognitive outcomes of the offspring in a multi-ethnic Asian cohort.

Methods: in the Growing Up in Singapore Towards Healthy Outcomes prospective mother-offspring cohort study, mothers responded to a structured NVP questionnaire at 26-28 weeks’ gestation (n=1172) and participants with severe NVP were confirmed using medical records. Children underwent multiple neurodevelopmental assessments throughout childhood. We conducted multivariable regressions with post-estimation predictive margins to understand the associations of NVP with offspring neurobehavioral outcomes, which included 1-year Infant-Toddler Social and Emotional Assessment, 1.5-year Quantitative Checklist for Autism in Toddlers, 2-year Bayley Scales of Infant and Toddler Development, 2- and 4-year Child Behavior Checklist, and 4.5-year Kaufman Brief Intelligence Test. Analyses were adjusted for household income, birth variables, maternal mental health, and other relevant medical variables. Cohen’s d effect sizes were calculated using standardized mean differences (μd).

Results: mothers were categorized into no (n=296, 25.3%), mild-moderate (n=686, 58.5%), and severe NVP (n=190, 16.2%), of whom 67 (5.7%) required admission. Compared to children of mothers who had no or mild-moderate NVP, children with exposure to severe NVP exhibited more externalizing behaviors (μd 2.0, 95% CI 0.3, 3.6; Cohen’s d=0.33) and social communication difficulties before 2 years (μd 4.1, 95% Cl 0.1, 8.0; d=0.38), both externalizing (μd 1.5, 95% CI 0.4, 2.6; d=0.43) and internalizing behaviors at 2 years (μd 1.2, Page 5 of 39Paediatric and Perinatal Epidemiology
6 95% CI 0.1, 2.2; d=0.35), and only internalizing behaviors after 2 years (μd 1.1, 95% CI 0.4, 2.0; d=0.37).

Conclusions: severe NVP is highly prevalent in this Asian cohort and may be adversely associated with multiple offspring neurobehavioral outcomes.
0269-5022
Syn, Nicholas L
1f60b2f5-f7fe-490e-b2a2-c1755ae0e0c4
Chan, Shiao-Yng
3c9d8970-2cc4-430a-86a7-96f6029a5293
Chia, Elisha Wan Ying
0e1b1a72-e7ae-43e1-b711-95061f00cb2f
Ong, Wei Xin
12a000f5-4edf-45b9-9ca9-a5f1fa3c78a2
Phua, Desiree
3393a01c-b22b-419e-8b8b-42fb333d6057
Cai, Shirong
0d23d2c5-889d-4f33-887f-b52e3d341ba4
Shek, Lynette P.
9a77403c-0e0c-4536-a5ad-628ce94b279a
Chong, Yap-Seng
492de658-aa9e-4b57-95bf-33109f4d2cc5
Daniel, Lourdes Mary
8092af24-31fe-42e5-be16-eda563047752
Broekman, Birit FP
19c57abe-90e5-477f-8cce-6c5b2ca6506f
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Meaney, Michael J.
5c6db45a-1f5b-4e1f-8c0b-07a8f7b29f66
Law, Evelyn C.
49ba55c6-ffc3-40a4-9ac4-6c05b5fd7f85
Syn, Nicholas L
1f60b2f5-f7fe-490e-b2a2-c1755ae0e0c4
Chan, Shiao-Yng
3c9d8970-2cc4-430a-86a7-96f6029a5293
Chia, Elisha Wan Ying
0e1b1a72-e7ae-43e1-b711-95061f00cb2f
Ong, Wei Xin
12a000f5-4edf-45b9-9ca9-a5f1fa3c78a2
Phua, Desiree
3393a01c-b22b-419e-8b8b-42fb333d6057
Cai, Shirong
0d23d2c5-889d-4f33-887f-b52e3d341ba4
Shek, Lynette P.
9a77403c-0e0c-4536-a5ad-628ce94b279a
Chong, Yap-Seng
492de658-aa9e-4b57-95bf-33109f4d2cc5
Daniel, Lourdes Mary
8092af24-31fe-42e5-be16-eda563047752
Broekman, Birit FP
19c57abe-90e5-477f-8cce-6c5b2ca6506f
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Meaney, Michael J.
5c6db45a-1f5b-4e1f-8c0b-07a8f7b29f66
Law, Evelyn C.
49ba55c6-ffc3-40a4-9ac4-6c05b5fd7f85

Syn, Nicholas L, Chan, Shiao-Yng, Chia, Elisha Wan Ying, Ong, Wei Xin, Phua, Desiree, Cai, Shirong, Shek, Lynette P., Chong, Yap-Seng, Daniel, Lourdes Mary, Broekman, Birit FP, Godfrey, Keith, Meaney, Michael J. and Law, Evelyn C. (2020) Severity of nausea and vomiting in pregnancy and early childhood neurobehavioral outcomes: the Growing Up in Singapore Towards Healthy Outcomes study. Paediatric and Perinatal Epidemiology. (doi:10.1111/ppe.12703).

Record type: Article

Abstract

Background: nausea and vomiting of pregnancy (NVP) affects 50 to 80 percent of women. The existing literature has examined NVP from the perspective of the mother, and relatively less is known about offspring outcomes.

Objectives: to study the relationships of NVP with social-emotional, behavioral, and cognitive outcomes of the offspring in a multi-ethnic Asian cohort.

Methods: in the Growing Up in Singapore Towards Healthy Outcomes prospective mother-offspring cohort study, mothers responded to a structured NVP questionnaire at 26-28 weeks’ gestation (n=1172) and participants with severe NVP were confirmed using medical records. Children underwent multiple neurodevelopmental assessments throughout childhood. We conducted multivariable regressions with post-estimation predictive margins to understand the associations of NVP with offspring neurobehavioral outcomes, which included 1-year Infant-Toddler Social and Emotional Assessment, 1.5-year Quantitative Checklist for Autism in Toddlers, 2-year Bayley Scales of Infant and Toddler Development, 2- and 4-year Child Behavior Checklist, and 4.5-year Kaufman Brief Intelligence Test. Analyses were adjusted for household income, birth variables, maternal mental health, and other relevant medical variables. Cohen’s d effect sizes were calculated using standardized mean differences (μd).

Results: mothers were categorized into no (n=296, 25.3%), mild-moderate (n=686, 58.5%), and severe NVP (n=190, 16.2%), of whom 67 (5.7%) required admission. Compared to children of mothers who had no or mild-moderate NVP, children with exposure to severe NVP exhibited more externalizing behaviors (μd 2.0, 95% CI 0.3, 3.6; Cohen’s d=0.33) and social communication difficulties before 2 years (μd 4.1, 95% Cl 0.1, 8.0; d=0.38), both externalizing (μd 1.5, 95% CI 0.4, 2.6; d=0.43) and internalizing behaviors at 2 years (μd 1.2, Page 5 of 39Paediatric and Perinatal Epidemiology
6 95% CI 0.1, 2.2; d=0.35), and only internalizing behaviors after 2 years (μd 1.1, 95% CI 0.4, 2.0; d=0.37).

Conclusions: severe NVP is highly prevalent in this Asian cohort and may be adversely associated with multiple offspring neurobehavioral outcomes.

Text
PPE-2019-4351.R3_Publication Proof - Accepted Manuscript
Download (430kB)

More information

Accepted/In Press date: 15 May 2020
e-pub ahead of print date: 23 June 2020

Identifiers

Local EPrints ID: 441504
URI: http://eprints.soton.ac.uk/id/eprint/441504
ISSN: 0269-5022
PURE UUID: 312f3994-99db-410e-b857-b47f067acc7e
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

Catalogue record

Date deposited: 16 Jun 2020 16:31
Last modified: 26 Nov 2021 02:35

Export record

Altmetrics

Contributors

Author: Nicholas L Syn
Author: Shiao-Yng Chan
Author: Elisha Wan Ying Chia
Author: Wei Xin Ong
Author: Desiree Phua
Author: Shirong Cai
Author: Lynette P. Shek
Author: Yap-Seng Chong
Author: Lourdes Mary Daniel
Author: Birit FP Broekman
Author: Keith Godfrey ORCID iD
Author: Michael J. Meaney
Author: Evelyn C. Law

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×